Periodic limb movements during sleep independent risk factor for CVD, suggests study

A recent study published in Journal of the American Heart Association uncovered periodic limb movements during sleep (PLMI) as the new independent risk factor for cardiovascular disease (CVD). The findings suggest that PLMI pose significant threat to cardiovascular health, even among individuals with obstructive sleep apnea (OSA) rates below 30 events per hour.

The study was conducted over a median follow-up of 5.1 years and focused on the relationship between PLMI, OSA (measured by apnea-hypopnea index or AHI) and the occurrence of incident CVD or mortality. Unadjusted analyses revealed a significant increase in the risk of the primary outcome with each 10-event per hour rise in both PLMI (hazard ratio [HR] 1.08) and AHI (HR 1.17). The outcomes of the study found no significant interaction between PLMI and AHI when assessing their combined impact on the primary outcome.

After adjusting for various factors such as the age, sex, race/ethnicity, obesity, baseline risk of mortality and Charlson Comorbidity Index were considered for analysis where PLMI emerged as a strong independent risk factor. The HR for the primary outcome was 1.05 for every 10 events per hour increase in PLMI where AHI did not maintain a significant association. Even after adjusting with the Framingham risk score the PLMI remained a significant contributor to the increased risk of CVD or mortality.

The study highlighting the significance of PLMI as a major risk factor for CVD events or mortality challenging the previous assumptions, particularly among individuals with AHI rates below 30 events per hour. Further research and clinical attention to periodic limb movements during sleep, opens new ways for understanding and addressing cardiovascular risks in sleep disorders.

Reference:

Zinchuk, A., Srivali, N., Qin, L., Jeon, S., Ibrahim, A., Sands, S. A., Koo, B., & Yaggi, H. K. (2024). Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality. In Journal of the American Heart Association. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/jaha.123.031630